What are the symptoms of diabetic kidney disease?

You are unlikely to have symptoms with early diabetic kidney disease - for example, you just have microalbuminuria. Symptoms tend to develop when the kidney disease progresses. The symptoms at first tend to be vague and nonspecific, such as feeling tired, having less energy than usual, and just not feeling well.

With more severe kidney disease symptoms that may develop include:

•Difficulty thinking clearly

•A poor appetite

•Weight loss

•Dry, itchy skin

•Muscle cramps

•Fluid retention which causes swollen feet and ankles

•Puffiness around the eyes

•Needing to pass urine more often than usual

•Being pale due to anemia

•Feeling sick

As the kidney function declines then various other problems may develop. For example, anemia and an imbalance of calcium, phosphate and other chemicals in the bloodstream. These can cause various symptoms, such as tiredness due to anemia, and bone thinning or fractures due to calcium and phosphate


End-stage renal failure is eventually fatal unless treated.


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42 Replies

  • Symptoms & Presentation differ from patient to patients depending on the age, sex & type of Diabetes also depending on the individual's lifestyle & environment etc.

  • Diabetic kidney disease (diabetic nephropathy) is a complication that occurs in some people with diabetes.

    In this condition the filters of the kidneys, the glomeruli, become damaged. Because of this the kidneys 'leak' abnormal amounts of protein from the blood into the urine. The main protein that leaks out from the damaged kidneys is called albumin.

    In normal healthy kidneys only a tiny amount of albumin is found in the urine. A raised level of albumin in the urine is the typical first sign that the kidneys have become damaged by diabetes.

    Diabetic kidney disease is divided into two main categories, depending on how much albumin is lost through the kidneys:

    1. Microalbuminuria. This is when the amount of albumin that leaks into the urine is between 30 and 300 mg per day. It is sometimes called incipient nephropathy.

    2. Proteinuria. This is when the amount of albumin that leaks into the urine is more than 300 mg per day. It is sometimes called macroalbuminuria or overt nephropathy.

  • A very good explanation from the learned Doctor for our knowledge.

  • Thank You..

  • I am 65 and diabetic for last 38 years. Two years back I had nephrectomy to remove one tumar from my right kidney. After that my urine ACR is slowly increasing from 25 to a present value of 43. My doctor says it's alright with one kidney. Do you have any other suggestion so that the increase of urine ACR is checked? Should I stop taking plant protein /diary products? I am little worried. I take fish regularly.

  • Sir I am not the Right Person to Answer this question, Your Doctor may be the right person or a Nephrologist.

  • its easy to prevent further progress into macroalbuminuria if u intervene at the microalbuminuria stage and have a good control of the BP and blood glucose .

  • That's True.



  • The regular medication that you take to control Diabetes along with the Diet & Exercise is sufficient to take care of your kidney too. But regular & timely checkup as advised by your Physician is necessary. Don't ignore the small symptoms, early diagnosis can help save your Organs.

  • Vigil over presence of sugar and albumin in urine with routine checks and ensuring every thing is in normal limits is a must. If any abnormal level, say even at marginal levels one has to approach nephrologist and diabetologist for corrective prescriptions.

  • Good Advice Sir.

  • Thank you for appreciation. I am not a doctor like you but understand nature's functioning orders.

  • just have the blood sugar and BP in good control.have some restriction on your protein intake.and reduce your salt intake to just 2 grams per day.use table salt for the necessary curries don"t add salt during cooking.

  • I have almost all the symptoms as described by Pallavi but I recently got my urine checked for proper kidney function and that shows all the parameters within normal limits. I think it very difficult to catch on the very early symptoms except to get the blood and urine sample tested every three months for creatinine and albumin.

  • You Are very True...Regular check up & Early approach to Doctor when you see any of the Symptom can help save your Kidney with very little intervention.

  • Your presumption is correct. It should be got checked periodically for every diabetes patient.

  • check for micro albumin in urine which is the early sign that if u diagnose u can revert to normal and as well u can prevent further progress..if u have the BP and blood glucose within allowed limits.

  • i m telling u my recent experience of medicine which brought my wife`s sugar normal within 25 days DAARU HALDI DIPPED IN A GLASS OF WATER IN D NYT ND IN D MORNING SHE DRUNK THIS WATER REGULARLY nd one more thing she used JAMUN SAT which i brought from HALDI GHATI RAJASTHAN, " MAHARANA PRATAP PERFUMERS " which is in maharana partap meusium she drunk it twice a day ,morn nd evening somebody told me that in d ground of HALDI GHATI there is speciality in jamun trees to control diabities. so i request all of u pl try it atleast once,

  • Thank You for Sharing your experience. What you told might work for some Patient But its better if they continue with their regular medicine & take advice from their Doctor before taking the medicine advised by you.

    Also you didn't mention your wife's age, type of Diabetes, what kind of medicine/insulin she was taking earlier to control diabetes & her blood sugar level before & after taking this medicine. So what worked for you might be dangerous for others if not consulted with their Doctor.

  • I agree with your comment Doctor. Hear say and unproven medications are of no use. Perhaps the person in subject might not have had diabetes at all. A good observer never makes trial on his health based matters on whatever is said by such persons.

  • Great advice! Thank you for saying it. I was thinking the same thing.

  • Hi Mr.pingal

    Honestly thanyou very much, for your intention to tell the fact that you have experienced, as we all suferrer are not suppose to go to Rajasthan so first need more clarity of the items availability location, and Dr. pallavi correctly said you have to disclose your wife's age and suffering details as well as she is under which medication, please reply calmly and some elaborately that other suferrer can take this nature gifted advantages, otherwise all the diabetic person will slowly be complled to go under a situation for daily /hourly Dr. check-up and medication throughout the life.


    Basudev hyderabad.

  • My question for Dr Pallavi.... I was diagnosed with Diabetes 2 in 2011. HbA1c was 10.6 !! After metformin doses it came down and within a year it was 5.9. At that time I was feeling some headache etc and my doctor advised me to quit medicine for some time. Since Sept,2012 I've not taken medicine for diabetese though I take med for hypertension, fish oil, zinc supplements and blood thinner. After 3 months and without med for diab my hbaic was again 5.9...again no med. after 3 months again yesterday my hbaic count is 6.4.

    Kidney fn test shows normal except in chloride which is higher by just 0.5 .

    Would you advise me not to take meds for some more time and continue with diet control and 45 minutes walk every day which I've following religiously ? I'm a strict veg and teetotler.

    I'm an executive with a large company and my profession demands me seated for almost 10 hours a day.

    Your advise please on how to go abt it all

  • I am very happy to see the way you are taking care of your Diabetes & sticking to a routine in spite of your hectic lifestyle.

    Its good that your Diabetes is under control with diet & exercise but if its getting increased then you should again start taking the medicine after consulting the right dosage from your Doctor.

    Ask your doctor about the Hypertensive medications & other supplements that you take in case they are the one responsible for an Increase in the level of Chloride.

  • Mr Atulya......great piece of advice !! I do check my BS almost every day. Fasting is mostly around 97 and PP varies from 135 to even 165 (on glucometer) depending upon my food intake. I'm told that the correct reading in glucometer is 5 less than shown on screen.

    My height is 5'7" and wt is 78 KG which had come down from 91 KG in 2011 to 76 till four months ago.Now a bit increased to 78. I'm trying to bring it further down by about 2 to 3 kg.

    My food intake is ,say 6 to 7 chapatis a day of wheat, gram and soyabeen mixed together. Previously I was successful in cutting down my after office snacks but of late it has increased a bit.

    However, if my hbaic shows, in a span of 21 months since diagnosed 1st in July,2011 , the counts as 10.6, 6.8 , 6.6, 6.5, 6.2,5.9,5.9 ,6.4 with last 2 readings (6 months) without taking any diabetese medicine ,then am I correct in continuing without medicines for 3 months more and see the hbaic again??

    Any more advice pl.

    Thnx a lot

  • 8 readings within a span of 21 months means possibility of overlaps of the 100 days required for A1c. tests. that may be the cause of minor variations after getting the levels down around6.0 and last lap indicates that you have over rided diet restrictions to some extent. Better try keep it hovering around 6.0 at the best. No harm will be caused at this level.

  • My Advice again to all readers is same Don't take anything without consulting & informing your Doctors. Ayurvedic medicines itself Don't have side effects but it can be dangerous if you are allergic to certain compound or when its metabolism alters with the other medicine that your are taking whether for Diabetes or any other disease.

  • As an ayurveda dr let me say,diabetes even it is type² classification of medicin n treatment differ frm person to person,all medicin vl not suite for all,it is related to ones constitution.so it is very important to select medicin under d supervision of an expert n experienced doctor.

    Txs to dr pallavis humble advises,atulya,vittal vijay n others for giving their experiences n advises.


  • dear mr vijai...even after three months of stopping your medicines your HbA1c is less than the normal limits.

    now we suggest 6.5 - 7% as normal ( corresponding blood glucose 130--156 mg% ). you probably might have had hypoglycemia which might be the reason for your head ache if your BP was otherwise normal.

    have periodic check up of your blood glucose...that is once in every month or if u have any discomfort as and when needed.

  • Thank You all the Contributors for Questions & Answers on this Blog. Today I am learning a lot about Diabetes & Its awareness among various members in this community.

  • First of all understanding diabetes is essential. Once caught with it, managing it in all possible SCIENTIFIC PROVEN way with the consultation and guidance of learned Doctors and meaningfully experienced persons is the right type of approach to live long..

  • having diabetes 2 for past 15yrs.now hbaic 9.2 microalbumin presently 60u.taking duotrol thrice.my sugar control is fluctuating depending food habits;fbs 126 ppbs236 plz suggest medicine and guide

    g.santhana krishnan madurai

  • please clarify my doubt

  • Sir, Please don't take advice on medicine from unknown people on internet & Blog. The fluctuation is not good you should consider some changes in Medicine & Diet to maintain a near normal level. Considering your age, weight, height & health the limit may wary but you should not get stressed by it, try to create a balance & consult your Doctor, They know you better. If you are not having faith on a particular doctor then search a new one. Diet & exercise is always in your hand so take good care of it.

  • Thank you doctor for this valuble information..Please tell wether it is curable permanently or not or patient remain dependable on medicine whole life

  • No it is not curable.

    With discipline you can live life without medicines also but depends at what stage it was detected and how sincerely you follow your diet and listen to your body. If your diet is loaded with CARBS )simple or complex really does not matter) then you will need medicines at some stage and insulin in extreme case.

  • an excellent description..very useful for the people having high BS ...thx

  • In case of diabetic patients whnever posperedial goes beyond 250 or there is sudden rise in blood pressure immediate tests for kidneys be performed and necessary steps be taken includind control of proteins in diets and consultation with phsian 5719

  • I would like ask the doctors who write in this blog, what is the best test to find out how much damage is caused by diabetics to the kidney. Is it enough to do Spot Urine Protein, Spot Urine Creatinine and P/C Ratio? Or is there any other better test to show if the kidney is getting damaged?

  • The Choice of Test depend on the clinical observation of the Doctor Or Nephrologist,

    But i am just describing 1 test which is useful to test the Kidney Function to the best of my knowledge....

    Estimated Glomerular Filtration Rate (eGFR)

    The eGFR kidney test is a test that estimates the total blood filtered through the kidneys every minute. Healthy kidneys filter 90ml to 120ml every minute of every hour. This occurs through the glomerular capillaries of the kidneys, hence the name.

    Originally the test was known as the Glomerular Filtration Rate test (or GFR test); the calculation required a substance to be injected into the bloodstream, then collection of the urine that passed for a 24hr period, and finally a test to measure how much of the substance found its way in to the urine collected. Thankfully scientists discovered they could easily estimate the kidney function (mainly through measuring serum creatinine levels) with great accuracy without needing to use this original testing procedure; making it a far simpler kidney test.

    The results of the eGFR test certainly give some of the most useful information about your kidney health out of all kidney tests. You see, whatever figure comes back as your result (10, 20, 50, 75, or 90ml/min), you can in fact replace the ‘ml/min’ at the end of the result – let’s use 55ml/min as an example – with a ‘%’ instead. So in this example, 55ml/min will become 55%.

    This figure can literally be used to show the total percentage of kidney function you have – This person has 55% of their kidney function left.

    Note: eGFR kidney test requires the following information to calculate the result: creatinine serum levels (from a blood sample drawn by a needle.), age, sex, and race.

    Note: A score of 60ml/min (60%) or less is considered the first stage of chronic kidney disease.

    Other Tests are:

    1. Creatinine

    2. 24hr Creatinine Clearance

    3. Urinalysis

    4. BUN

    5. Kidney Biopsy

    6. Imaging

    I am not the qualified person to decide on which test is the best for a particular person.I am a Physical Therapist so i have my limitations.


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